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/Title (Prvalence et incidence deux ans de la tubulopathie proximale infraclinique \(TPI\) chez des patients mono-infects par le virus de lhpatite B chronique \(VHB\) traits par entcavir \(ETV\) ou tnofovir disoproxil \(TDF\))
/Author (Brayette Anas)
/Creator (Word)
/ModDate (D:20180928164721+02'00')
/Subject (Introduction : Le TDF est risque potentiel de nphrotoxicit par tubulopathie contrairement lETV. Lobjectif principal de notre tude tait de comparer, laide de marqueurs prcoces, la prvalence de la TPI deux ans chez des patients traits \(TDF ou ETV\) versus nafs. Mthodes : Etude prospective, multicentrique avec suivi sur deux ans de patients monoinfects chroniquement par le VHB, nafs ou dbutant un traitement \(ETV ou TDF\). Le DFGe, la phosphatmie, la 25\(OH\)D3 et les marqueurs de TPI ont t recueillis trimestriellement. La TPI tait dfinie par un seuil de rabsorption tubulaire du phosphate \(TmPi/DFGe\) infrieur 0.8 mmol/L et/ou un taux dexcrtion fractionnelle de lacide urique \(EFAU\) suprieur 10%. Rsultats : Parmi 196 patients analysables, 138 navaient pas de TPI linclusion : 84 nafs, 28 traits par ETV et 26 traits par TDF. A deux ans, aucun patient navait un DFGe infrieur 50 mL/min ou une hypophosphatmie \(< 0.48 mmol/L\). La prvalence de la TPI deux ans ntait statistiquement pas diffrente entre le groupe ETV vs Naf \(21.1% versus 30.7%, p=0.4172\) et le groupe TDF vs Naf \(50% versus 30.7%, p=0.3167\). Lincidence de la TPI au cours du suivi tait respectivement de 13,3%, 25,5% et 52,9% dans le groupe ETV, Naf, et TDF. La mdiane de survie sans TPI, analysable uniquement dans le groupe TDF, tait de 5.9 mois. Conclusion : La TPI semble plus frquente chez les patients traits par TDF comparativement au groupe Naf, bien que cette diffrence ne soit pas statistiquement significative.)
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2018-09-03T05:39:08Z
Word
2018-09-28T16:47:21+02:00
2018-09-07T12:57:49+02:00
Mac OS X 10.13.6 Quartz PDFContext
application/pdf
Prévalence et incidence à deux ans de la tubulopathie proximale infraclinique (TPI) chez des patients mono-infectés par le virus de l’hépatite B chronique (VHB) traités par entécavir (ETV) ou ténofovir disoproxil (TDF)
Brayette Anaïs
Introduction : Le TDF est à risque potentiel de néphrotoxicité par tubulopathie contrairement à l’ETV. L’objectif principal de notre étude était de comparer, à l’aide de marqueurs précoces, la prévalence de la TPI à deux ans chez des patients traités (TDF ou ETV) versus naïfs. Méthodes : Etude prospective, multicentrique avec suivi sur deux ans de patients monoinfectés chroniquement par le VHB, naïfs ou débutant un traitement (ETV ou TDF). Le DFGe, la phosphatémie, la 25(OH)D3 et les marqueurs de TPI ont été recueillis trimestriellement. La TPI était définie par un seuil de réabsorption tubulaire du phosphate (TmPi/DFGe) inférieur à 0.8 mmol/L et/ou un taux d’excrétion fractionnelle de l’acide urique (EFAU) supérieur à 10%. Résultats : Parmi 196 patients analysables, 138 n’avaient pas de TPI à l’inclusion : 84 naïfs, 28 traités par ETV et 26 traités par TDF. A deux ans, aucun patient n’avait un DFGe inférieur à 50 mL/min ou une hypophosphatémie (< 0.48 mmol/L). La prévalence de la TPI à deux ans n’était statistiquement pas différente entre le groupe ETV vs Naïf (21.1% versus 30.7%, p=0.4172) et le groupe TDF vs Naïf (50% versus 30.7%, p=0.3167). L’incidence de la TPI au cours du suivi était respectivement de 13,3%, 25,5% et 52,9% dans le groupe ETV, Naïf, et TDF. La médiane de survie sans TPI, analysable uniquement dans le groupe TDF, était de 5.9 mois. Conclusion : La TPI semble plus fréquente chez les patients traités par TDF comparativement au groupe Naïf, bien que cette différence ne soit pas statistiquement significative.
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